Acceptability of HIV self-testing to support pre-exposure prophylaxis among female sex workers in Uganda and Zambia: results from two randomized controlled trials.

Journal: BMC infectious diseases

Volume: 18

Issue: 1

Year of Publication: 2018

Affiliated Institutions:  International Clinical Research Center, University of Washington, Seattle, USA. John Snow, Inc, Lusaka, Zambia. International Research Consortium, Kampala, Uganda. Uganda Health Marketing Group, Kampala, Uganda. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA. Francis I. Proctor Foundation, University of California San Francisco, Parnassus Ave, Room SJ, San Francisco, CA, USA. catherine.oldenburg@ucsf.edu.

Abstract summary 

HIV pre-exposure prophylaxis (PrEP) is highly effective for prevention of HIV acquisition, but requires HIV testing at regular intervals. Female sex workers (FSWs) are a priority population for HIV prevention interventions in many settings, but face barriers to accessing healthcare. Here, we assessed the acceptability of HIV self-testing for regular HIV testing during PrEP implementation among FSWs participating in a randomized controlled trial of HIV self-testing delivery models.We used data from two HIV self-testing randomized controlled trials with identical protocols in Zambia and in Uganda. From September-October 2016, participants were randomized in groups to: (1) direct delivery of an HIV self-test, (2) delivery of a coupon, exchangeable for an HIV self-test at nearby health clinics, or (3) standard HIV testing services. Participants completed assessments at baseline and 4 weeks. Participants reporting their last HIV test was negative were asked about their interest in various PrEP modalities and their HIV testing preferences. We used mixed effects logistic regression models to measure differences in outcomes across randomization arms at four weeks.At 4 weeks, 633 participants in Zambia and 749 participants in Uganda reported testing negative at their last HIV test. The majority of participants in both studies were "very interested" in daily oral PrEP (91% Zambia; 66% Uganda) and preferred HIV self-testing to standard testing services while on PrEP (87% Zambia; 82% Uganda). Participants in the HIV self-testing intervention arms more often reported preference for HIV self-testing compared to standard testing services to support PrEP in both Zambia (P = 0.002) and Uganda (P < 0.001).PrEP implementation programs for FSW could consider inclusion of HIV self-testing to reduce the clinic-based HIV testing burden.ClinicalTrials.gov NCT02827240 and NCT02846402 .

Authors & Co-authors:  Ortblad Katrina F KF Chanda Michael M MM Musoke Daniel Kibuuka DK Ngabirano Thomson T Mwale Magdalene M Nakitende Aidah A Chongo Steven S Kamungoma Nyambe N Kanchele Catherine C Bärnighausen Till T Oldenburg Catherine E CE

Study Outcome 

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Statistics
Citations :  Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587–2599. doi: 10.1056/NEJMoa1011205.
Authors :  11
Identifiers
Doi : 503
SSN : 1471-2334
Study Population
Female
Mesh Terms
Adult
Other Terms
Female sex workers;HIV self-testing;Pre-exposure prophylaxis;Uganda;Zambia
Study Design
Study Approach
Country of Study
Uganda
Publication Country
England